Plan Building Specialist
Work Location: Remote
ASR Health Benefits is a rapidly growing third-party administrator of health plans, including medical, dental, vision, short-term disability, Section 125 and consumer-directed health plans. We administer these health plans through dedicated client service teams, consisting of staff members from each department at ASR who work together to meet our clients’ needs.
Position Summary:
The Plan Building Specialist designs, configures, and maintains complex benefit plans within QicLink or VBA platform. This role translates client requirements into detailed plan structures, including coverage, copays, deductibles, and benefit limits while ensuring regulatory compliance.
This position supports the accurate and efficient administration of self-funded benefit plans (medical, dental, vision, and disability) and continuously identifies opportunities to improve automation and system performance.
ASR offers a competitive compensation and benefits package designed to support your health, financial well-being, and work-life balance. Apply today!
Key Responsibilities:
Interpret plan design requirements from internal documentation and client materials to build, maintain, and validate benefit plans
Configure and support self-funded benefit plans across multiple lines of coverage (medical, dental, vision, disability)
Ensure all plan designs comply with applicable state and federal regulations (e.g., ACA)
Contribute to enhancements in plan design methodology to improve automation and claims processing efficiency
Troubleshoot and resolve plan configuration and functionality issues
Serve as a subject matter expert for internal inquiries related to plan design, implementation, and system configuration
Assist in developing documentation and training materials for new plan designs, configurations, and methodologies
Participate in system upgrades, including testing and implementation activities
Collaborate with business teams to resolve plan design challenges and optimize system capabilities
Perform additional duties as assigned
Preferred Skills and Qualifications:
Strong analytical skills with the ability to translate client needs into effective plan designs
High attention to detail and accuracy in system configuration
Excellent verbal and written communication skills
Strong problem-solving abilities
Ability to manage multiple priorities and deadlines independently
Proficiency in Microsoft Office and data analysis tools
Solution-oriented mindset with a focus on continuous improvement
Demonstrated willingness to learn and grow
Detail-oriented and highly accurate
Self-motivated and proactive
Collaborative and adaptable
Continuous learner with a strong curiosity for system and process improvement
Agreement that your likeness (e.g., name, image, voice, and/or video) may be used in internal and external materials with customers or prospective customers
Preferred Experience:
3+ years of health insurance experience, preferably in:
Claims adjudication
Plan building or benefit configuration
Experience working with self-funded plans and diverse plan designs
Familiarity with QicLink and/or VBA (preferred but not required)
Knowledge of industry code sets (ICD-10, HCPCS, CPT, CDT, etc.)
Understanding of healthcare regulations (HIPAA, ACA, CAA, ERISA, COBRA, CAQH CORE, etc.)
Essential Functions:
This role may require extended sitting, regular computer and office equipment use, clear communication, and occasional lifting of up to 10–15 pounds. Reasonable accommodations for individuals with disabilities will be provided as needed.
Confidentiality: This position involves access to protected health information (PHI) and other sensitive data. Employees are expected to maintain strict confidentiality in accordance with HIPAA, company privacy policies, and all applicable federal and state regulations.